Ventilator-associated pneumonia in an intensive care unit: A comparative analysis of clinical and microbiological characteristics of COVID-19 and non-COVID-19 patients.

INTRODUCTION

The incidence and microbiological characteristics of coronavirus disease-2019 (COVID-19) associated ventilator-associated pneumonia (VAP) remain a clinical concern. The present study investigates the risk factors associated with VAP and compares the clinical and microbiological characteristics between the patients with and without COVID-19.

MATERIALS AND

METHODS

This retrospective case-control study was conducted in a tertiary intensive care unit (ICU) between March 2020 and February 2023. Patients with COVID-19 were identified through positive SARS-CoV-2 polymerase chain reactionresults, while non-COVID-19 patients served as controls. Demographic characteristics, comorbidities, clinical parameters, and microbiological data were analyzed. Risk factors for VAP were determined using multivariate logistic regression analysis. The Kaplan-Meier method was used to estimate the cumulative probability of VAP.

RESULT: A total of 327 mechanically ventilated patients were enrolled, of whom 154 developed VAP. COVID-19 emerged as an independent predictor of VAP, conferring a 2.47-fold increased risk (p= 0.008). COVID-19 VAP patients had a higher prevalence of acute respiratory distress syndrome (ARDS) (p< 0.001), increased corticosteroid use (p= 0.004) and lower APACHE scores (p< 0.001). Both ICU and hospital case fatality rates were significantly increased in COVID-19 VAP patients. Klebsiella pneumoniae was the predominant pathogen in COVID-19 VAP patients, followed by Acinetobacter baumannii as the second most common pathogen.

CONCLUSIONS

COVID-19 is a significant risk factor for VAP, with distinct clinical and microbiological characteristics compared to non-COVID-19 VAP. The greater occurrence of ARDS, corticosteroid use, and multidrug-resistant organisms in COVID-19-associated VAP highlights the urgent need for individualized antimicrobial strategies aimed at reducing infection-related morbidity and mortality.